Clinical studies have indicated that increased serum
cholesterol levels raised the risk of
tendinopathy in
hypercholesterolemia, but the effect of
cholesterol on tendon-derived stem cells (TDSCs) and its underlying mechanism have not been studied. The purpose of this study is to investigate the association between
cholesterol and
tendinopathy in vitro and in vivo, and its underlying molecular mechanism as well. In TDSCs, the effect of
cholesterol was assessed by quantitative polymerase chain reaction, western blot analysis, and immunofluorescence staining. Intracellular levels of
reactive oxygen species (ROS) was detected, using flow cytometry. The link between nuclear factor (NF)-κB signaling and the effect of
cholesterol was evaluated using a representative IκB
kinase (IKK) inhibitor,
BAY 11-7082. In addition, Achilles tendons from
apolipoprotein E mice fed with a high-fat diet were histologically assessed using
hematoxylin and
eosin staining and immunohistochemistry. We found that high
cholesterol apparently lowered the expression of tendon cell markers (
collagen 1, scleraxis, tenomodulin), and elevated ROS levels via the NF-κB pathway both in vitro and in vivo. The ROS scavenger
N-acetylcysteine (NAC) and
BAY 11-7082 reversed the inhibiting effect of
cholesterol on the tendon-related gene expressions of TDSCs. Moreover, NAC blocked
cholesterol-induced phosphorylation of IκBα and p65. Significant histological alternation in vivo was shown in Achilles tendon in the hypercholesterolemic group. These results indicated that high
cholesterol may inhibit the tendon-related gene expressions in TDSCs via ROS-activated NF-кB signaling, implying pathogenesis of
tendinopathy in
hypercholesterolemia and suggesting a new mechanism underlying
hypercholesterolemia-induced
tendinopathy.